Burwell Expected To Advance
ONE STEP CLOSER: The Senate is scheduled to vote today to end debate on Sylvia Mathews Burwell's nomination for HHS secretary. Thanks to the "nuclear option," it will only take 51 votes to move forward on her nomination--and she's all but guaranteed to get even more than that. Although some conservatives have angled for a bigger fight around Burwell's nomination, she's garnered enthusiastic support from several Republican senators, and won eight GOP votes when the Finance Committee voted on her nomination. Conservatives may want to use up the limited debate time that would remain after today's procedural vote, but even if they do, she's clearly on track to take the helm at HHS soon.
Top Health Care News
BURWELL: Judging from her emphasis on work-home balance in previous leadership positions, the nominee for HHS Secretary could change how Washington works...or it could change how she works. (Laura Bassett and Jeffrey Young, Huffington Post)
WHITE HOUSE CONSIDERING HEAD OF CLEVELAND CLINIC FOR NEXT VA SECRETARY: The White House has reportedly approached Delos "Toby" Cosgrove--high profile hospital executive, Vietnam veteran, surgeon, and Washington outsider--to be the next Veterans Affairs Secretary following the resignation of Eric Shinseki last week, and Cosgrove is reportedly "seriously considering" the position. (Damien Paletta, Christopher Weaver, and Janet Adamy, Wall Street Journal)
- A 2013 profile of Cosgrove and the Cleveland Clinic. (Matthew Herper, Forbes)
- Why Cosgrove could be an ideal candidate for the position--if he wants it. (Dan Diamond, Advisory Board Company)
- Cosgrove would likely get support from both parties. In the 2012 election, Obama and Romney agreed that the Cleveland clinic is one of the nation's leading health systems. (Dan Diamond, California Healthline)
OPEN ENROLLMENT HAS ENDED, BUT OUTREACH EFFORTS CONTINUE FULL-SPEED AHEAD: The administration and outside groups continue to sign up individuals whose qualifying life events make them eligible to enroll in coverage outside the designated enrollment period. In Minnesota, officials say that they have averaged 1,100 special enrollments every day--the same number as during open enrollment. (Sam Stein, Huffington Post)
- Despite the continued changes in enrollment, the administration has discontinued enrollment reports between the close of the first open enrollment period in March, and the start of the second in November. (Kyle Cheney, Politico Pro)
MIDWEST VA HOSPITALS ALSO HAD SECRET WAIT LISTS, BUT IN SMALLER SCALE THAN ARIZONA: VA officials sent letters to Senators Pat Roberts and Jerry Moran of Kansas, saying that the department kept 10 "secret waiting lists" of veterans in need of care at facilities in Kansas, Missouri, Indiana, and Illinois. At least 96 veterans waited more than 90 days for treatment at seven facilities in those states; while eight of the 10 lists "served to complement authorized lists to more fully support Veteran care and access," the two others "placed Veterans at risk," according to the letters. (John Milburn, Associated Press)
GOP OFFERS ALTERNATIVE VA HEALTH BILL: Senator John McCain and four other Republican senators proposed legislation Tuesday that would make it easier for veterans to see a private doctor if appointment wait times are too long within the VA system. Independent Senator Bernie Sanders--chairman of the Senate Veterans Affairs Committee--proposed legislation this week that would allow veterans who can't get timely care to go to community health centers, military hospitals or private doctors; authorize the VA to lease 27 new health facilities in 18 states; and give the VA secretary authority to remove senior executives within 30 days of being fired for unsatisfactory performance. McCain and Sanders will meet Wednesday to try to agree on legislative language for veterans health. (Matthew Daly, Associated Press)
CAN CIVILIAN HEALTH CARE--AND CONGRESS--FIX THE VA PROBLEMS?: "While veterans' service organizations support many of the measures before Congress, the majority of such groups say the VA's medical care is excellent once vets get access to it. And they worry that the private sector doesn't have needed expertise." (Quil Lawrence, NPR)
LAWMAKERS DEMAND VA HOSPITAL DATA: Two Representatives leading Congress's probe into the VA health scandal called on the agency to disclose metrics of treatment outcomes at VA hospitals, following a report that some facilities have significantly higher rates of mortality and dangerous infections than others. (Damien Paletta and Thomas M. Burton, Wall Street Journal)
DEMS CAMPAIGN ON MEDICAID EXPANSION: "This growing support to expand Medicaid comes as Democrats feel increasingly comfortable touting the health care law, a slow change buoyed this spring by the positive news of Obamacare's 8 million enrollees. They frame it as an issue that forces Republicans to explain why they want to deny health care access to poor people at zero cost to states—at least for the first three years while the federal government picks up the entire tab." (Jennifer Haberkorn, Politico)
- However, a new Washington Post-ABC News poll shows that Obamacare isn't motivating Democrats in the 2014 election--about three times as many Republicans view Obamacare as one of the most important issues in the 2014 campaign as Democrats who say the same. (Aaron Blake, Washington Post)
HOUSE GOP SPLIT ON WHETHER TO PUSH OBAMACARE ALTERNATIVE: "Some have even begun to suggest publicly that this year is not the time to vote on an alternative that likely would die in the Democratic-controlled Senate or face a veto threat from Obama. That argument looks especially compelling in light of Republican hopes of taking over the Senate in November...Even ardent opponents now question the need to repeal the law in full. Repeal remains the official GOP position but is widely acknowledged to be impractical now that the initial problems with the enrollment website have subsided, people have signed up and popular provisions such as a ban on denying coverage because of pre-existing conditions have taken hold." (Erica Werner, Associated Press)
GUN CONTROL GROUPS RALLY IN SUPPORT OF SURGEON GENERAL NOMINEE: The National Rifle Association has held up Obama's nomination of Vivek Murthy as next surgeon general in the Senate since February, because of his support for gun control. (Elise Viebeck, The Hill)
Medicare and Medicaid
MEDICARE WILL COVER SCREENING FOR HEPATITIS C: The decision could open the federal government up to paying for Sovaldi, Gilead's new $84,000 treatment for the disease, which has been found to be remarkably effective, but has prompted debate over drug costs. (Alex Wayne, Bloomberg News)
AT LEAST 2.9 MILLION PEOPLE CAUGHT IN MEDICAID ENROLLMENT BACKLOG. A combination of technical problems, opposition to the law, and a surge of applicants has left many in insurance limbo while they await their Medicaid eligibility determination. (Rebecca Adams, CQ Roll Call)
- The problems with the Medicaid enrollment system had been largely put on the backburner during the open enrollment period for private insurance coverage. (Sophie Novack, National Journal)
Abortion and Pregnancy
COURT UPHOLDS INJUNCTION ON ARIZONA ABORTION DRUG RESTRICTION: A federal appeals court ruled Tuesday that the state's strict rule on abortion drugs--which would ban women from taking RU-486, the most common abortion-inducing pill, after the seventh week of pregnancy--will continue to be blocked while a lawsuit against the regulations continues to play out. (Paul Elias and Bob Christie, Associated Press)
- The decision creates a split with two other circuit courts in Texas and Ohio on medication abortion restrictions, which could potentially push the issue to the Supreme Court. (Irin Carmon, MSNBC)
STUDY: RAPE VICTIMS MAY BE CHARGED FOR SOME MEDICAL PROCEDURES: "The patchwork of state laws that govern what's included in a forensic medical exam can present bigger financial problems for rape victims. The law says that exams should include a patient interview and history, an examination for physical trauma, including penetration or force, and evidence collection.The law doesn't require states to cover tests for pregnancy or sexually transmitted infections as part of the MFE, though many states do so, the study [carried out by the Urban Institute, George Mason University and the National Sexual Violence Resource Center] found. They're less likely to cover treatment for those infections, pregnancy or for injuries sustained during the rape." (Michelle Andrews, Kaiser Health News)
IS APPLE CREATING AN EHR MONOPOLY?Apple's new health-tracking tool will integrate with electronic health records maintained by Epic Systems -- which already stores the electronic health data for about 40 percent of Americans. That kind of integration has obvious benefits (better and more accessible information about your health), but it could also help shield Epic from competitors and make it harder for other companies to challenge the iPhone/Epic juggernaut. (Adrianna McIntyre, Vox)
- @binarybits: I predict Apple will run away screaming when they realize how miserable it is to develop health care IT systems.
GOP QUESTIONS HHS AUTHORITY TO REGULATE IT PRODUCTS: "In a Tuesday letter to Karen DeSalvo, national coordinator for health information technology at HHS, GOP leaders questioned whether the Office of National Coordinator has the statutory authority to regulate health IT products based on a new report and whether it has the authority to receive user fees under its budget request." (The Hill Staff)
PROCEDURAL VOTE ON BURWELL CONFIRMATION: The Senate will hold a roll call vote to end debate on the nomination of Sylvia Mathews Burwell to replace Kathleen Sebelius as the next Department of Health and Human Services Secretary. The vote will be held following confirmation votes for three judicial nominations, which will begin at 11 a.m.
HEALTH PRIVACY SUMMIT: Healthcare providers, IT innovators, national and international privacy experts from academia, industry, and government will convene for a two-day conference at Georgetown Law Center.